Comments on forward pressure and other reflectance-based quantities for delivering stimuli to the ear

The forward pressure has been proposed as an "optimal" reflectance-based quantity for delivering stimuli to the ear during evoked otoacoustic-emission measurements and audiometry. It is motivated by and avoids detrimental stimulus-level errors near standing-wave antiresonance frequencies when levels are adjusted in situ. While enjoying widespread popularity within research, the forward pressure possesses certain undesirable properties, some of which complicate its implementation into commercial otoacoustic-emission instruments conforming to existing international standards. These properties include its inability to approximate the total sound pressure anywhere in the ear canal and its discrepancy from the sound pressure at the tympanic membrane, which depends directly on the reflectance. This paper summarizes and comments on such properties of the forward pressure. Further, based on previous published data, alternative reflectance-based quantities that do not share these properties are investigated. A complex integrated pressure, with magnitude identical to the previously proposed scalar integrated pressure, is suggested as a suitable quantity for avoiding standing-wave errors when delivering stimuli to the ear. This complex integrated pressure approximates the magnitude and phase of the sound pressure at the tympanic membrane and can immediately be implemented into standardized commercial instruments to take advantage of improved stimulus-level accuracy and reproducibility in the clinic.